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General NPI Number Information
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NPI Number | 1952067720
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Entity Type | Individual
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Provider Name | SHIRAN GLASS LMSW
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Gender | Female
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 20 W PARK AVE STE 207
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City | LONG BEACH
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State | NY
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Zip | 11561-2019
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Country | US
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Telephone | 516-253-6244
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Fax |
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Provider Business Mailing Address
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Address Line | 285 BLACKHEATH RD
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City | LIDO BEACH
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State | NY
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Zip | 11561-4838
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Country | US
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Telephone | 516-477-6882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 114837
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 101388
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License Number State | NY
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